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1990, 05-14 Permit App: 90002049 MechanicalMECHANICAL PERMIT AiPPLICATION FORM Information Worksheet JOB STREET ADDRESS: .r ,1 CITY/STATE/ZIP:PARCEL NUMBER: OWNER: PHONE NUMBER: MAILING ADDRESS: (Street) (City/State) (zip) '-J CONTRACTOR • Z,�L �� LICENSE NUMBER: PHONE NUMBER: ;7"h2� MAILING ADDRESS: 10 5- /Cjjd��C'_� _ ��� -�, /.cif l��p ;7 (Street) City/State) (Zip) MECHANICAL WORKSHEET/FEE DESCRIPTION SCHEDULE NUMBER OF UNITS X EACH TTNIT = AMOUNT DUCTWORK SYSTEM _ _ _ _ _ _ _ _ _ _ _ _ WOODSTOVE/INSERT _ _ _ _ _ _ _ _ _ - _ _ GAS WATER HEATER _ _ _ _ _ _ _ _ _ _ _ _ HEATING EQUIPMENT <100,000 BTU _ _ _ _ _ HEATING EQUIPMENT +100,000 BTU _ _ _ _ _ GAS PIPING (EA OUTLET) _ _ _ _ _ _ _ _ _ REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP) REFRIG 101-500M BTU_ _ _ _ _ _ _ _ _ _ _ REFRIG 501-1,000M BTU_ _ _ _ _ _ _ _ _ _ REFRIG 1,001-1,750M BTU_ _ _ _ _ _ - _ - REFRIG +1,750M BTU _ _ _ _ _ _ _ _ _ _ _ HEAT PUMP & AIR CONDITIONER 0-3 TONS _ _ HEAT PUMP & AIR CONDITIONER 3-15 TONS _ HEAT PUMP & AIR CONDITIONER 15-30 TONS _ HEAT PUMP & AIR CONDITIONER 30-50 TONS _ HEAT PUMP & AIR CONDITIONER +50 TONS _ _ VENTILATING FANS _ _ _ _ _ _ _ _ _ _ _ _ EVAPORATIVE COOLERS_ _ _ _ _ _ _ _ _ _ _ TYPE I HOOD (PER 121 OR 12- PTN. OF HOOD) TYPE II HOOD _ _ _ _ _ _ _ _ _ _ _ _ CLOTHES DRYER_ _ _ _ _ _ _ _ _ _ _ f_ _ RANGE_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ i_ _ GAS LOG_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ MISCELLANEOUS (NOT COVERED ELSEWHERE)_ _ UNLISTED GAS APPLIANCE <400,000 BTU_ _ _ UNLISTED GAS APPLIANCE >400,000 BTU_ _ _ USED APPLIANCE <400,000 BTU_ _ _ _ _ _ _ USED APPLIANCE >400,000 BTU_ _ _ _ _ _ _ AIR HANDLER <10,000 CFM _ _ _ _ _ _ _ _ AIR HANDLER >10,000 CFM _ _ _ _ _ _ _ _ x$10.00 = x 25.00 = x 10.00 = x 12.00 = x 15.00 = x 1.00 = x 12.00 = x 20.00 = x 25.00 = x 35.00 = x 60.00 = x 12.00 x 20.00 = x 25.00 = x 35.00 = x 60.00 = x 10.00 = x 10.00 = x 50.00 = x 10.00 = x 10.00 = x 10.00 = x 10.00 = x 10.00 = x 50.00 = x100.00 = x 50.00 = x100.00 = x 12.00 = x 15.00 = _ r _ _ SUBTOTAL $ 06 PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT NOTE: MINIMUM PERMIT FEE IS $35.00 FEE DUE _ $ 37,0r, SIGNATURE Spokane County Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 9-9260 (509) 456-3675